Best Guide for Selection of Surgical Instruments - Cutting - Grasping - Retractors

Types of Surgical Instruments

Surgical Instruments may be roughly categorized by function :

• Cutting instruments which include scissors, knives , surgical blades and scalpel handles.

• Grasping or holding instruments which include hemostatic forceps and tissue forceps.

• Retractors hold incisions open or hold an organ (or tissue) .

Few accessories are needed for surgery. These include clamps, from large towel clamps to delicate vessel clips and bulldog clamps, sutures, binocular loupes, drills and more.

Cutting Instruments

           Following are the tips to keep in mind when selecting an appropriate pair of surgical               scissors:

Fine tip scissors are ideal for use in very restricted spaces. They are perfect for right or left hand use, and are designed for procedures, which require a delicate incision of tissue. Quick, accurate cuts with minimal tissue damage can be made using these sharp blades.

Curve tipped scissor is a good choice when you want to avoid cutting underlying tissues.

Scissors with a heavier construction (like Metzenbaum, Mayo and Super Cut scissors) are useful for cutting thicker tissue or vessels.

                                          

Metzenbaum Scissor                        Castroviejo Scissor

Grasping Instruments

               Surgical forceps may be mainly divided into two categories, Ring forceps (also                       called hemostats, hemostatic forceps and locking forceps) and Thumb forceps                       (frequently called tweezers or pinning forceps). Some tips to keep in mind when                     selecting an appropriate forcep:

• Reverse forceps are self-closing. Just squeeze them to open. They provide uniform tension.
• Ceramic tipped forceps are non-porous, rust and heat resistant and insulated.
• Straight tip forcep is used for general precision work and slightly curved or fully curved tips gives more visibility.

                                 Reverse Forceps                                                          Ceramic Tipped Forceps

                                                            Halsted Mosquito Forceps

           Ring forceps are  also known as hemostats or locking forceps. They are used for                   grasping, holding firmly or exerting traction upon objects mainly for delicate                           oprations. They are hinged and look like ring scissors. Hemostatic forcep has a                     locking mechanism called a ratchet, which is used for clamping.

           Common types of ring forceps include: 

• Kelly hemostats is used to clamp larger vessels or grasp tissue. Kelly hemostats and Rochester forceps look similar. However. Kelly hemostat has shorter serrations. Rochester hemostats can go a little deeper.

                                                         

            

 Kelly-Rankin Hemostats                                                       Rochester-Oschner Hemostats

     

• Hartman Mosquito forcep has fine, short tips and a serrated jaw. They are used as hemostats for clamping small blood vessels and in fine tissue dissection when the incision is shallow. We can use them to clamp small blood vessels or hold fine sutures. For a lighter and longer hemostat, we can go for Halstead Mosquito Forceps.

                                                               

 Hartman Mosquito Forceps                                           Halstead Mosquito Forceps

Allis tissue forceps have sharp teeth to grip heavy tissue. As they can cause damage, they typically hold tissue that is to be removed.

Crile hemostats are similar to Halsted Mosquito forceps  but little larger.

Rochester-Oschner forceps are heavy hemostats used for clamping large vessels or grasping dense tissue. They are serrated for grasping and often have teeth at the tip also.

 Rochester-Oschner Forceps

        Rochester-Pean   

Rochester-Carmalt Forceps

        Thumb forceps are spring forceps used by compression between thumb and forefinger          and are used for grasping, holding or manipulating body tissue. They have no ratchet            in the handle. Tissue forceps generally have teeth which gives a better grip on tissues          while minimizing tissue damage.

        Common types of thumb forceps are :

• Adson tissue forceps which are designed for grasping delicate tissues, and they have 1x2 teeth.
• Bonn tissue forceps are designed for delicate work.

Adson Tissue Forceps

Bonn Tissue Forceps 

Retractors

Retractors are used to hold an incision or a open wound  to hold an organ or tissue out of the way to expose what's underneath. 

• An assistant, a robot or the surgeon must hold hand retractors while doing a procedure.
• Self-retaining retractor has a mechanical device for holding tissue during surgery. It allows hands-free operations. Self-retaining retractor has a screw, ratchet or some type of clamp to hold the tissue by itself. Thus the surgeon can operate with two free hands.
• Wire retractors are the simplest type of retractor. Usually the wire has some spring so that the surgeon can pinch it together, position and release it. They also free up the surgeon's hands. 

Hand Retractors

Self-Retaining Retractor

Wire Retractor

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